Please complete the following form as thoroughly as possible. Marketech will evaluate and when qualified, we'll use the information to create a sample home page. This is only the start. Before we begin actual design on your website, more research will need to be done |
First Name Last Name
Company Address
City State ZipCode
Phone Fax
E-Mail Address
1.0 Do you have an existing website? Yes No
If YES, what is your web address?
2.0 Do you have a domain name registered? Yes No
If YES, what is your domain name?
3.0 Please check all of the Website Features that may be a consideration for your website. Leave blank if you don't know. All features will be explained in detail.
Hold the "Ctrl" key down to make multiple selections.
4.0 Please check all of the pages you would initially consider for your website.
Hold down the "Ctrl" key to make multiple selections.
5.0 Any other ideas, comments or suggestions?
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